Write 14 pages thesis on the topic ethical and legal issues in the couseling profession. All in all, these dilemmas and decisions have made me more prudent and more discerning in my approaches to patient care. This essay will now serve as my reflective ethical autobiography with various sources and theories used to help support and evaluate the choices I have made during my immersion. Discussion One of the main teachings which were drilled to us by our professors was the fact that there were various ethical principles which we had to follow and consider with each patient that we cared for. These main ethical principles include: beneficence, patient autonomy or self-determination, non-maleficence, and justice. These principles helped me develop my sense of right or wrong. Whenever I doubted my actions or did not know whether my actions were right or wrong, I always considered these four ethical principles as a guide or as a foundation for my decisions. Beauchamp and Childress identified these ethical principles which should govern the ethical practice of our profession. They discuss that the principle of autonomy is basically about the personal rule of oneself which is apart or free from the influences of others and from the limitations which negate meaningful choice (Beauchamp and Childress, 1994). This autonomous decision making process allows the individual to act in accordance with his plans and his choices. Without such autonomy, an individual is dictated by others and is incapable of acting on his desires or plans (Beauchamp and Childress, 1994). In other words, patient autonomy is about allowing the patient to make his own decisions about his care – without forcing him or influencing him to decide in a particular way. In my practice, I often had to explain to patients the different types of care or interventions which can be implemented in their favor. There were times when I was tempted to influence their choices and to sway them towards making decisions which, I felt, were more favorable to the patients and to me. But noting that I might be unjustly and unfairly influencing them to make decisions on their care, I ended up being more restrained and being more balanced in explaining possible choices in their care. By allowing them to make their own choices, I was able to afford more respect to my patients as individuals. Patient autonomy is also about respecting the patient’s decision even if such decision is not the best decision for him. One time, I encountered a patient who refused further care and counseling. I knew that he needed to be in therapy and he needed to undergo intensive rehabilitation. However he wanted to undergo a less structured rehabilitation process and he wanted to do it outside the mental health institution. Even if I knew that his choices may not be effective in rehabilitating him, ethics dictated that I had to respect his choice. And so we released him and allowed him to make his own choices of care. The principle of beneficence is based on doing acts of kindness for others (Beauchamp and Childress, 1994). In essence, this principle “asserts an obligation to help others further their important and legitimate interests” (Beauchamp and Childress, 1994, p. 260). In applying this principle to my counseling practice, I often encountered situations where I knew that my patients needed more intensive counseling. One time, I encountered a high school student whom I assessed to be depressed.

 

I will pay for the following article Microbe on Escherichia coli. The work is to be 2 pages with three to five sources, with in-text citations and a reference page. Part I: Organism Information Organism Escherichia coli Organism Type: Bacteria Organism Structure: E. coli is a gram-negative bacterium with rod shaped cells 2.0 (μm) long with a diameter of 0.5 (μm). The bacterium grows best at 37°C but some strains have successfully multiplied in controlled laboratory settings at even 49°C. It is a facultative anaerobe reproducing using mixed-acid fermentation requiring low hydrogen levels to ferment simple sugars into formic acids. E. coli is also found with other hydrogen consuming organisms like sulphate-reducing bacteria (Hayhurst, 2004).

Organism Characteristics: The bacterium is usually found in the lower intestinal tract of warm-blooded animals and humans. Most of the strains found in the gut are actually beneficial to the host by inhibiting the growth of other harmful bacteria and synthesizing vitamins, like K2. However, some serotypes can cause severe food poisoning in humans. One common strain, O157:H7, releases strong toxins, specifically enterotoxins, that damage and infect the host’s intestinal lining (Rasko, 2011). At times, a small colony of only 10-100 cells in enough to cause infections in children. The incubation period of these types of infection causing strains can range anywhere from a few hours to a week. The bacteria penetrate and thrive in the intestinal lining, eating away at the mucosa (Hayhurst, 2004).

Part II: Disease Information

Diseases caused: Food poisoning

Mode of Transmission: Usually through fecal-oral transmission and coming in contact with contaminated foods and drinks

Portal of Entry into body: Main route through oral ingestion

Area of body organism attacks: Mucous lining of the intestines

Symptoms of Disease: Symptoms usually manifest themselves in adults after 3-4 days of being infected consisting mostly of mild diarrhea, abdominal cramping and nausea. In severe cases the diarrhea can become bloody and the infection can cause kidney problems leading to pale skin, fever, chills, and bruising. Most healthy adults get better within a weak while for infants and young children it can take longer. In rare and extreme cases the virulent strain can also cause pneumonia, hemolytic uremic syndrome (kidney failure), and dehydration through diarrhea, eventually leading to death in young children and older adults (Hayhurst, 2004).

Part III: Treatment and Prevention

Diagnosis: Usually the doctor carries out a physical examination and a medical history involving a series of questions about many of the symptoms. The questions will also try to determine travelling history, recently eaten foods, contact with contaminated foods and unpasteurized dairy products, and antibiotic use. The physical examination consists of checking the patient’s temperature, blood pressure, skin color, stomach tenderness and a rectal exam. If E. coli infection is suspected, the doctor will request a stool culture examination to determine the presence of the infectious strain and its toxins (Rasko, 2011).

Treatment: There aren’t any medications and vaccines yet to protect against E. coli infections. One of the best methods to relieve symptoms is to get plenty of rest and fluids in order to decrease dehydration due to diarrhea. If bloody diarrhea occurs, diarrhea medicine and antibiotics should be avoided as these slow the digestive system, allowing even more of the poison produced by the bacteria to be absorbed. In extreme cases where kidney failure or blood problems occur, blood transfusion and dialysis will be needed (Hayhurst, 2004).

Prevention: The primary way to prevent infections is to limit the exposure to contaminated foods and water, unpasteurized dairy products, and avoiding cross-contamination. Meats should be cooked thoroughly at high temperatures and raw fruits and vegetables should be washed before use. Hands should be washed before and after preparing food, using the washroom and coming into contact with animals. When travelling, it is best to avoid ice and tap water (Hayhurst, 2004).

Part IV: Historical information

1885: Theodor Escherich, a German pediatrician, discovered E. coli and named it Bacterium coli commune because it was found in the colon of healthy adults (Hayhurst, 2004).

1917: Nissle, a nonpathogenic strain of E. coli, started being used in medicine to treat many gastroenterological diseases like, inflammatory bowel disease (Hayhurst, 2004).

1997: The DNA sequence of E. coli was first completed and published. The circular DNA was found to have 4.6 billion base pairs and a very high coding density (Hayhurst, 2004).

2011: An outbreak of the strain O104:H4 began in Germany leading many people to be infected with hemolytic-uremic syndrome. Gradually 11 other countries were affected including some parts of North America. Later that year, the Federal Institute for Risk Assessment in Germany announced that fenugreek seeds from Egypt were the likely cause of the outbreak (Rasko, 2011).

Part V: Works Cited

Hayhurst, Chris. (2004). Epidemics, Deadly Diseases Throughout History: E. coli. New York, NY: The Rosen Publishing Group, Inc.

Rasko, D. A., et al. (2011). Origins of the E. coli Strain Causing an Outbreak of Hemolytic–Uremic Syndrome in Germany. The New England Journal of Medicine, 365, 709-717. Retrieved from http://www.nejm.org/doi/full/10.